A cost-analysis of two approaches to infection control in a lung function laboratory

Background: The Thoracic Society of Australia and New Zealand (TSANZ) guide lines for infection control in respiratory laboratories are based on a 'Uni versal Precautions' approach to patient care. This requires that one-way br eathing valves, flow sensors, and other items, be cleaned and disinfected b etween patient use. However, this is impractical in a busy laboratory. The recent introduction of disposable barrier filters may provide a practical s olution to this problem, although most consider this approach to be an expe nsive option. Aim: To compare the cost of implementing the TSANZ infection control guidel ines with the cost of using disposable barrier filters. Methods: Costs were based on the standard tests and equipment currently use d in the lung function laboratory at The Alfred Hospital. We have assumed t hat a barrier filter offers the same degree of protection against cross-inf ection between patients as the TSANZ infection control guidelines. Time and motion studies were performed on the dismantling, cleaning, disinfecting, reassembling and re-calibrating of equipment. Conservative estimates were m ade as to the frequency of replacing pneumotachographs and rubber mouthpiec es based on previous equipment turnover. Labour costs for a scientist to re process the equipment was based on $20.86/hour. The cost of employing a cas ual cleaner at an hourly rate of $14.07 to assist in reprocessing equipment was also investigated. The new high efficiency HyperFilter(TM) disposable barrier filter, costing $2.95 was used in this cost-analysis. Results: The cost of reprocessing equipment required for spirometry alone w as $17.58 per test if a scientist reprocesses the equipment, and $15.56 per test if a casual cleaner is employed to assist the scientist in performing these duties. In contrast, using a disposable filter would cost only $2.95 per test. Using a filter was considerably less expensive than following th e TSANZ guidelines for all tests and equipment used in this cost-analysis. Conclusions: The TSANZ infection control guidelines are expensive and impra ctical to implement. However, disposable barrier filters provide a practica l and inexpensive method of infection control.